To be fully engaged in providing Uncompromised Safety, Superior Quality, Memorable Patient/Customer Experiences, and Financial Stewardship by ensuring the financial integrity of Health First,Inc/HF Medical Management by
performing established financial processes that enable and expedite the billing and collections. This includes: Customer Service, billing claims according to Federal/State, and Managed Care rules, regulations and compliance guidelines, patient account research and resolution, insurance verification and benefits determination, identification of reimbursement issues, resolution of credits and issuance of refunds, identification of payment variance invoices, follow up and resolution of denied claims.
Demonstrates competence in all business office applications and systems.
Apply coding conventions in order to resolve claim issues and discrepancies with medical necessity.
Ensures that documentation/claims meet Federal and State Compliance guidelines.
Excellent communication and problem solving skills. Provides outstanding customer service.
Provides financial assistance to our patients such as: financial arrangements, Medicaid eligibility, and, indigent programs. Completes assistance application and reviews with established guidelines to approve or disapprove.
Assists with training new staff on departmental specific procedures which includes computer applications.
Recognizes and identifies payer denial trends, makes recommendations pertaining to process changes.
Analyze Aged Trial Balance by payer, performs follow up, managing A/R at assigned dunning levels.
General knowledge of managed care contracts. Identifies payment variance trends, takes corrective action
High School Diploma required. Associate Degree preferred.
Two years progressive experience in Healthcare Billing and AR Follow-up, or related field required.
Two years experience in a health care facility, or related field.
Thorough knowledge of medical terminology, preferred.
Thorough knowledge of coding (ICD-9, CPT and HCPCS), preferred.
Thorough knowledge of state and federal programs, and managed care contracts, preferred.
Thorough knowledge of accounting principals, preferred.
Computer experience required. Proficient in standard Microsoft Windows applications.
Health First - 19 months ago